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Account#: ]2410 <br /> I. IDENTIFICATION <br /> BUSINESS NAME (4) CAR QUEST BUSINESS PHONE(5) 209.943-1000 <br /> SITE ADDRESS (6) 1645MINER AVE <br /> Street No. Direction Street NameStreet Type A t/Bld Suite <br /> CITY (7) STOCKTON STATE(8) CA ZIP(9) 95205 <br /> DUN& (10)NA SIC CODE(4 DIGIT#) (11) 5012 <br /> BRADSTREET <br /> OPERATOR (12)JERRY JOHNSON OPERATOR PHONE(13) 209-943-1000 <br /> NAME <br /> II.BUSINESS OWNER <br /> OWNER NAME(14) GOLDEN STATE SUPPLY OWNER PHONE(15) 209-943-1000 <br /> OWNER MAILING ADDRESS(16) 34928 MC MURTREY WAY <br /> (If different from site address) <br /> CITY(17) BAKERSFIELD STATE(18) CA ZIP(19) 93305 <br /> III. ENVIRONMENTAL CONTACT <br /> CONTACT NAME(20) JERRY JOHNSON CONTACT PHONE(21) 209-943-1000 <br /> MAILING ADDRESS(22) <br /> (If different from business 0 IFANAVE NA <br /> mailing address) Street No. Direction Street Name Street Type A t/Bld Suite <br /> CITY(23) NA STATE(24) El <br /> ZIP(25) NA <br /> Primary IV. EMERGENCY CONTACTS Secondary <br /> NAME(26) NAME(3 1) <br /> JERRY JOHNSON BART SCOTT <br /> TITLE(27) MANAGER TITLE(32) REGIONAL MANAGER <br /> BUSINESS PHONE(28) 209-943-1000 BUSINESS PHONE(33) 916-446-4666 <br /> 24-HOUR PHONE(29) 209-670-6576 24-HOUR PHONE(34) 916-873-2181 <br /> PAGER#(30) NA PAGER#(35) NA <br /> EXTREMELY HAZARDOUS SUBSTANCES (EHS) <br /> ON-SITE EHS (36) NO If yes,and above Threshold Planning Quantities,attach a sheet of paper with a general <br /> description of the process and principle equipment involving the EHS. <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION(37) Provide information requested on the back of this form <br /> NAME OF DOCUMENT PREPARER(38) JERRY JOHNSON <br /> NAME OF OWNER/OPERATOR(39) GOLDEN STATE SUPPLY DATE(40) <br /> DATE REC'D: 1/21/07 <br />